Breastfeeding

Oversupply: Too much of a good thing

With the emphasis put on building a good milk supply—which, don’t get me wrong, is important—and the folks who talk about all of the foods, drinks, herbs, and pills they take to build their milk supply, it would be easy to think that more is always better when it comes to the amount of milk you make. The reality is that too much milk—sometimes called “oversupply”—can be difficult to manage.

Breastfeeders with oversupply be like... (Photo credit: Rogerio Lira via Flickr Creative Commons)
Breastfeeders with oversupply be like… (Photo credit: Rogerio Lira via Flickr Creative Commons)

Here are some reasons why there is such a thing as too much milk:

  • Oversupply can be painful. Your milk-making abilities may be astounding, but that doesn’t mean there’s no limit to places to store the results. Engorgement isn’t comfortable, and people with oversupply can find themselves in a near-constant state of engorgement. They’re left with the choice of removing milk very frequently—which is inconvenient and helps continue a high level of milk production, for better or worse—or discomfort—which can lead to plugged ducts or mastitis. And if you let your breasts stay too full for too long, that can reduce milk supply too much.
  • The milk flow can be hard for a baby to handle. Breasts that are overly enthusiastic may have babies that aren’t able to keep up with their flow. When breasts are very full, the milk flows faster. While this is something that babies may eventually learn to deal with, it can cause a lot of frustration for baby and parent alike. Babies who have trouble handling milk flow may do things such as pull off the breast frequently; choke, cough, or sputter when feeding; act fussy at the breast; clamp down on the nipple in an attempt to curtail the flow; or slip off the breast.
  • Too much milk can be tough on tummies. You might have heard the term “foremilk/hindmilk imbalance” at some point. This terminology is applied a little too broadly and, for the majority of people, is not a concern. The fast-flowing milk from very full breasts, though, picks up less fat on the way through the milk ducts. If a baby is filling up on this less-fatty milk, your baby might experience things like fussiness; larger-than-normal amounts of gas; frequent feedings; explosive, green, watery, foamy, or even bloody stools; and high weight gain.
  • You may experience leaking and other embarrassing situations. In the early days of lactating, a bit of leaking is normal and common. We joke about it and there’s an expectation that you might end up leaking through your shirt at some point. And while some people keep leaking a bit as time goes on, it can become particularly embarrassing for someone who has an oversupply. It’s one thing to leak through your clothing while you’re on maternity leave, and another when it happens during an important meeting because you forgot to change your breast pads.

What causes oversupply, and how can I avoid it?

Some cases of oversupply are caused by well-meaning advice to add in pumping or special milk-boosting foods. When you need help building milk supply or your baby is not transferring milk well, expressing milk manually or with a pump (and sometimes galactagogues) is needed. On the other hand, when your milk supply is good and your baby is breastfeeding well, adding milk expression or galactagogues can cause you to make too much milk.

Other cases are related to individual hormones. Polycystic ovarian syndrome (PCOS), for one, tends to contribute to either low supply or oversupply, and it’s hard to know who will experience which before delivery.

Oversupply can’t always be avoided, but one point of prevention seems clear: If you do not have a sound reason to boost your milk supply, don’t try to do so. 

How do you fix oversupply? 

Have an IBCLC (or, if an IBCLC isn’t available, an experienced peer breastfeeding supporter such as a La Leche League leader) observe breastfeeding and/or pumping. They can look for signs of oversupply and help you come up with a plan that will fit your needs. If you’re pumping as well as breastfeeding, that plan might include weaning off of pumping. If you’re only breastfeeding, an IBCLC can discuss strategies to increase comfort for you and your baby, which may include trying to reduce your milk supply. Diana West covers several strategies here.

One way to reduce milk supply is a technique called block feeding. A word of caution: Block feeding reduces milk supply and is best used temporarily and under the guidance of a professional. Using it at the wrong time, such as when your milk supply is being calibrated in the early weeks of breastfeeding, or when you milk supply is good but your baby is not breastfeeding well, can reduce your milk supply too much.

The symptoms of oversupply for parent and baby show overlap with other common conditions, like tongue tie, food sensitivities, and even low milk supply. (You can have a forceful milk ejection reflex, which has many of the same signs, without having a large milk supply.) This is why having an expert observe and assess breastfeeding is important.

This milk supply is juuuuuust right.

goldilocks_sm

Channel Goldilocks and set your sights on a “just-right” amount of milk. Your body’s goal is to make the just-right amount of milk for your baby; your body will avoid wasting resources on making breastmilk that isn’t going to good use. In most cases, you’ll match your milk supply to your baby’s (or babies’ ) needs by breastfeeding frequently enough and ensuring your baby is breastfeeding well. If you have questions about how much milk you’re making, well, that’s what people like me are here for.

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